Category Archives: responsibility

Why we read and re-read the doctor-essayist

Dalrymple is identified by an acute English journalist (also a skilled and powerful debater), Peter Hitchens, as

one of the greatest men of our age [second item in Hitchens’s 6th August 2017 column in the UK newspaper the Mail on Sunday].

For decades, Hitchens reminds us, Dalrymple

worked in a major British jail, listening to the excuses and self-justifications of people who had done terrible things to others, and to themselves.

Refusing to follow fashion,

and genuinely concerned for these often very sad characters, he treated them as adults, urging them to take responsibility for their actions instead of offering excuses for them. Many, who had come to despise authority, were glad to be up against someone they could not easily fool.

Hitchens’s guess is that many of those Dalrymple treated

benefited greatly from his tough-minded approach. He didn’t fill them with pills or substitute one drug for another. His observations of the way heroin abusers feign terrible discomfort, after arriving in prison and being deprived of their drug, is both funny and a badly needed corrective to conventional wisdom.

All this, Hitchens notes, is to be found in the Dalrymple collection The Knife Went In (2017).

The title, a quotation from an actual murderer, is an example of the way such people refuse to admit they had any part in the crimes they commit. The knife somehow got there and went into the victim, by itself. It is a series of short, gripping real-life stories in which he recounts his experiences with our broken, lying penal system with its fake prison sentences and its ridiculous form-filling as a substitute for action.

The book is mainly about prisons and crime, but, says Hitchens,

it tells a deep truth about the sort of society we have become. It is one in which almost nobody is, or wants to be, responsible for anything.

Hitchens concludes:

A future historian, a century hence, will learn more about 21st-century Britain from this book than from any official document.

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Corrupt physicians, irresponsible patients

screen-shot-2017-02-21-at-08-38-12In the last three years alone, writes Dalrymple,

almost as many Americans have died as a result of opioid overdose as have been killed in all US military actions since the end of the Second World War.

The evidence suggests that the ‘epidemic’

started with, and has been maintained by, the irresponsible, incompetent, and sometimes corrupt prescribing of opioids by a portion of the American medical profession.

But this

does not altogether absolve the patients themselves of responsibility for their predicament—unless no one is ever responsible for anything.

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The hope of a dilemma-free world is naïve where it is not power-hungry

screen-shot-2016-12-14-at-19-05-57The problem, says Dalrymple, with a nationalised health system’s

incontinent sharing of risk

is that

it deprives people of one possible motive for behaving responsibly. They believe, not without reason, that someone will always pick up the pieces for them at no cost to themselves. Irresponsibility thrives where there is no penalty for it.

He points out, however, that the problem with individualised insurance is that

it may place intolerable or unsustainable burdens on people through no fault of their own.

In short,

incontinent sharing of risk is unjust: too little sharing of risk is inhumane. Since both justice and humanity are desirable qualities, but not always compatible, now one, now the other, will be the more important; but the tension between them will remain.

Dalrymple writes:

That ethical decisions sometimes cannot be made that are indisputably correct, that entail no injustice or no inhumanity, is difficult for rationalists and utilitarians to accept. They want every division to be without remainder. They want a formula that will decide every question beyond reasonable doubt. They want a universal measure of suffering, so that the worth (in units of suffering averted) of every medical procedure can be known and compared. There is a cognitive hubris at play, according to which information will resolve all our dilemmas; and if our dilemmas have not been answered, it is only because we do not have enough information.

As for the doctor,

he cannot be so limitlessly compassionate as to deny patients’ responsibility where it exists, nor should he deny his patients his compassion by blaming them even when they are to blame.

Moral weakness par excellence

Close down the drug addiction clinics!

Addicts, writes Dalrymple,

would then have to face the truth, that they are as responsible for their actions as anyone else.

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The curse of welfarism

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Young British mothers

Dalrymple writes that there is in the West, and especially in Britain,

a rising tide of neglect, cruelty, Sadism, and joyous malignity.

Where does the evil come from? Dalrymple points out that

a necessary, though not sufficient, condition is the welfare state, which makes it possible, and sometimes advantageous, to behave like this.

Fatherhood

Young British fathers

The State

is the parent of last resort—or of first resort. The State gives assistance to the mother of any child, once it has come into being. In matters of public housing, it is advantageous for a mother to put herself at a disadvantage, to be a single mother, without support from the fathers of the children and dependent on the State for income. She is then a priority; she won’t pay local taxes, rent, or utility bills.

Screen Shot 2015-10-27 at 10.39.30As for the men, the State

absolves them of all responsibility for their children. The State is father to the child. The biological father is free to use whatever income he has as pocket money, for entertainment and little treats. He is reduced to the status of a child, though a spoilt child with the physical capabilities of a man: petulant, demanding, querulous, self-centred, and violent. The violence escalates and becomes a habit. A spoilt brat becomes an evil tyrant.